Shared trauma, resilience, and growth: A roadmap toward transcultural conceptualization.

Objective: Countless communities worldwide are exposed directly and subsequently to the effects of massive-scale collective stressors, from natural disasters to human-caused. In contexts of collective adversity, health care providers who are also members of these communities share and interdependently affect the range of responses their patients have. We aim to conceptualize this spectrum, termed shared trauma, shared resilience, and shared growth. Method: In this metasynthesis, we review the literature on these underacknowledged dynamics globally. We include prior conceptualizations of direct and indirect trauma, collective trauma, cultural context, and the COVID-19 pandemic toward clearer conceptualization of shared mental health in global collective stressor contexts. Results: Most trauma and resilience research focuses on prevailing concepts and measures with questionable cross-cultural applicability. These works usually center on acute, highly distressing threats to physical safety at the individual level. The scarce literature on shared trauma describes it as a rare phenomenon, entailing conflicting messages of narrative accounts within contexts of few cultures with medium to high degrees of individualism. There has been little consideration of other non-Western and indigenous communities with more collectivist values and collective trauma histories. There is limited understanding of these concepts as they pertain to the vast majority of cultures. As a result, shared trauma, resilience, and growth have been poorly conceptualized, differentiated, or empirically researched. Conclusions: We propose uniquely inclusive models of shared trauma, resilience, and growth. These models reflect the cumulative effects and interplay of direct to indirect, acute to chronic, individual to collective, and historic to transgenerational factors influenced by cultural context. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Telehealth Literacy as a Social Determinant of Health: A Novel Screening Tool to Support Vulnerable Patient Equity.

Background: Telehealth has evolved as a solution to COVID-19 isolation precautions and remote care with well-established health, socioeconomic, and practical benefits. However, there are many gaps in the current literature regarding telehealth use among older, low health literate, and resource-limited populations. There are ethical considerations that warrant understanding this digital divide. Objective: The objective of this review is to propose the Telehealth Literacy Screening Tool (TLST) for use in older adults and support the future inclusion of telehealth literacy as an important social determinant of health (SDOH). Methods: Initially a four-week outreach was performed that targeted older adults and low-health literate patients at the MedVantage Clinic (MVC) within Ochsner Health (OH) to identify common barriers to patient engagement with the OH Epic MyChart telehealth platform. Themes from those barriers directed a meta-synthetic review of the methods and ethical considerations of current, validated technological and telehealth literacy screening tools. Those findings were reported based on the standards of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Results: Based on the barriers identified during our MVC patient outreach, PRISMA-reported review of telehealth literacy screening research, and evaluation of the MyChart platform and the technological resources required for its use; we developed a multidimensional questionnaire for telehealth literacy screening of older adults. Conclusion: The TLST is designed to identify patients in need of additional interventions for successful connection to telehealth services. This is an important step towards addressing the ethical obligation to decrease disparities in telehealth literacy for vulnerable populations and identifying telehealth literacy as a SDOH.